C964 – Travel premium - Hospital In-Patient - Nights
OHIP Surgical Procedures Code — GENERAL PREAMBLE · Schedule of Benefits
C964 is a travel premium for a non-elective special visit to a hospital in-patient during the night (00:00h to 07:00h). This premium compensates for the travel required to attend to the patient and is only payable for travel from one location to another. It must be claimed with an appropriate assessment fee (using an 'A' prefix code) and is subject to general special visit rules outlined in to . It is not payable for travel within the same hospital complex or between buildings on the same hospital campus (). As per , only one travel premium is eligible per trip, regardless of the number of patients seen.
When to Use
- Use C964 when you are called back to the hospital from your home or office between 00:00 and 07:00 to attend to an in-patient for an urgent, non-elective clinical issue.
- Use C964 when you attend to a patient in a hospital facility that is geographically distinct from your current location, provided the visit is initiated by a request for a non-elective service.
Common Pitfalls
- Billing C964 when you are already physically present in the hospital for other duties, as travel premiums require a distinct trip from an external location.
- Attempting to claim C964 alongside an 'H' prefix emergency department code, which is strictly prohibited under the General Preamble rules for special visit premiums.
- Submitting C964 for multiple patients seen during the same trip; only one travel premium is payable per trip regardless of the number of patients assessed.
Billing Tips
- Always pair C964 with the appropriate 'C' prefix assessment code and the C996 'First person seen' premium to maximize the value of the night-time call-back.
- Ensure your documentation explicitly records the time of the call and the time of arrival at the hospital to justify the non-elective nature and the specific time-window requirements.
Effective: April 1, 2026
GP. General Preamble
GENERAL PREAMBLE
Premium
Special Visit Premiums (Table III - Hospital In-Patient)
The time at which the special visit takes place must be documented on the medical record.
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